M1363 HCPCS Level II code: Patients who did not have a follow-up assessment within 120 days of the index assessment
M1363 is the HCPCS code for “Patients who did not have a follow-up assessment within 120 days of the index assessment” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
M1363Patients who did not have a follow-up assessment within 120 days of the index assessment
Short description: Pts no f/u 120 dys
HCPCS · United States
Medicare details
The indicators CMS publishes with M1363 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2024
Where M1363 sits
- 1M codesMedical services and quality measures
- 2Active code M1363Patients who did not have a follow-up assessment within 120 days of the index assessment
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code M1363 mean?
M1363 is the HCPCS code for “Patients who did not have a follow-up assessment within 120 days of the index assessment” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover M1363?
CMS lists M1363’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside M1363
All M codesM1357Patients who had a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessmentM1358Patients who did not have a reduction in suicidal ideation and/or behavior upon follow-up assessment within 120 days of index assessmentM1359Index assessment during the denominator period when the suicidal ideation and/or behavior symptoms or increased suicide risk by clinician determination occurs and a non-zero…M1360Suicidal ideation and/or behavior symptoms based on the c-ssrsM1361Suicide risk based on their clinician's evaluation or a clinician-rated toolM1362Patients who died during the measurement periodM1364Calculated 10-year ascvd risk score of >= 20 percent during the performance periodM1365Patient encounter during the performance period with hospice and palliative care specialty code 17M1366Focusing on women's health mips value pathwayM1367Quality care for the treatment of ear, nose, and throat disorders mips value pathwayM1368Prevention and treatment of infectious disorders including hepatitis c and hiv mips value pathwayM1369Quality care in mental health and substance use disorders mips value pathway